Donor and Recipient Age May Predict Kidney Transplant Outcome

Toshika Linton and Stefan Tullius after Linton’s surgery in April 2010.

Toshika Linton, 81, underwent a kidney transplant at BWH in April 2010. Today, not even a year later, she reports she is feeling “great” and is even planning a trip to Hawaii this spring to visit her daughter.

Linton’s surgeon, Stefan Tullius, MD, PhD, chief of the Division of Transplant Surgery, says that her smooth recovery is in part attributed to the fact that the kidney she received came from a donor who was close to Linton in age. In fact, in a recent study, a team of BWH researchers from Transplant Surgery and Renal Medicine found that matching donor and recipient age improves outcomes.

“Toshika received an organ from an older patient whose circulation discontinued prior to the removal,” said Tullius, the lead author of the paper, which appeared in the October issue of Annals of Surgery. “Because she was close in age to the donor, she required fewer anti-rejection medications and had a very positive transplant outcome.”

The current standard for matching donor organs with recipients is primarily based on the recipient’s position on the waiting list.

“Right now, 70-year-old patients are competing with 20-year-old patients for the same organs,” Tullius said. “Our research supports a proposal to change the way that we allocate donor organs. We’ve found that when the donor and recipient are more closely matched in age, we are using each organ in the most efficient and best way.”

Researchers also found that with every decade of increasing recipient age, there was an incremental increase in transplant survival. They attribute this to a reduced immune response in older patients, which leads to lower rates of rejections in these older patients.

The study was conducted using the United Network for Organ Sharing (UNOS) database; researchers analyzed data from more than 100,000 patients receiving kidney transplants.

More than half of the patients in the U.S. who are waiting for a kidney transplant are over the age of 50, and more than half of all transplanted kidneys come from donors 50 years or older.